During the late twentieth century a number
of controversies erupted in the United States over such questions
as the genuineness of multiple personality phenomena and the recovery
of lost memories of sexual abuse. On one side psychotherapists
insisted that the phenomena in question were genuine and that they had
been overlooked because of bias and ignorance. On the other side
critics argued that overly zealous therapists were unwittingly suggesting
the phenomena to their patients and thereby creating unnecessary morbidity.
What characterizes these episodes is the polarization that develops between
those who have seen the phenomenon and those who have not. It is an embarrassing
polarization, seemingly more appropriate to religious disputes of earlier
centuries than to twentieth century medical science. While these controversies
died down, it is apparently only because the adversaries have withdrawn
from combat. As periodic eruptions show, however, both sides still cling
to their polarized views of the essential truths in these important clinical
issues.
For the historian, what is striking is how frequently such controversies
seem to recur. From the royal commission investigating Mesmer's claims,
to the debates over somnambulism and spiritualism, through the debate between
Charcot and Bernheim over hypnosis, and to the various schools of
psychoanalysis the same question has reemerged. Insight into the social-psychology
of these controversies has not been lacking, though it seems as if it must
be rediscovered with each new eruption of controversy.
In 1886 the Belgian philosopher
Joseph Delboeuf boldly proposed a social-psychological and historical
explanation of the polarizing controversy he was witnessing, that has resonance
through the twentieth century to the controversies we have recently been
experiencing. "Doubtless there is an action of the hypnotist
on the hypnotized--like master, like disciple" he argued in a manner that
many would agree with, then and now. Delboeuf, however, went further insisting
that, "... the subjects themselves, primarily the first , shape… the person
who molds them and, without his knowledge, dictate his method and
tactics to him. In this way, turning the proverb upside down, we
can say : like subject, like master' [Delboeuf, August 1886, 149].
Delboeuf's formulation
not only turns the proverb upside down but provides a way of understanding
how polarizing controversies and schools of psychotherapy develop in psychiatry.
Delboeuf has, however, received little attention in the anglophone world.
He has a small place as a footnote to the history of psychoanalysis. Freud
quoted one of Delboeuf's dreams at length to demonstrate how forgotten
memories influence the creation of dreams and introduced the interpretation
of his own dreams by quoting Delboeuf's modest statement that, “Every
psychologist is obliged to admit even his weaknesses if he believes that
doing so will throw light on some obscure problem" [Freud, 1900/1961,105].
In France Jacqueline Carroy and Francois Duyckaerts have appreciated
Delboeuf's broader significance [Carroy, 1991; Duyckaerts, 1992]. Following
up on their work, this paper uses detailed published accounts of Delboeuf’s
investigations of patients at the Salpêtrière in Paris, his
observations on the subjects of the stage hypnotist Donato and his own
experiments in Liege Belgium to describe the observations that led him
to his memorable insight into the social-psychology of polarizing controversies
in psychiatry.
Delboeuf achieved his insight during the polarizing
confrontation over hypnosis that occurred in France during the 1880s
between the illustrious Parisian neurologist, Jean Martin Charcot and Nancéén
professor of medicine, Hippolyte Bernheim. Charcot argued that hypnosis
was pathological and could be most readily, if not exclusively
found, among hysterics. He had made his reputation as a neurologist by
studying dramatic symptom complexes as prototypes of disease entities.
Following this procedure in his study of hypnosis, he claimed that he had
discovered a distinct three stage process consisting of lethargy, catalepsy
and somnambulism, which could be elicited in hysterics.
Bernheim , by contrast, saw nothing pathological about hypnosis, and no
connection with hysteria. Bernheim came to hypnosis by observing the clinical
practice of a country doctor A. A. Liébeault. Liébeault's
aim was to heal his peasant patients of a wide variety of ailments, using
hypnosis as a vehicle to suggest to them that they return to health. From
his observations of Leibault Bernheim persuaded himself that hypnosis did
not involve characteristic phenomenon, such as Charcot had found,
but merely the imposition of the will of a hypnotist on a simple and passive
subject [Ellenberger, 1970; Gauld, 1992].
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Born in 1831 and Delboeuf received his doctorate in philosophy and letters in 1855. Before turning his attention to hypnosis, Delboeuf had an active and successful career in philosophy and psychology. He was a skeptic, a rationalist, and an experimental psychologist, with a profound commitment to the concept of freedom. Though skeptical about much of what he heard reported about hypnosis, he was not willing to dismiss the phenomena as mere imposture. As a rationalist he was determined to avoid being seduced by the 'mysteries' of hypnosis and to connect the explanation somnambulistic phenomena to the realm of psychological phenomena already analyzed by scientists [Delboeuf, 1887, 113]. In 1869, for example, he anonymously wrote articles offering naturalistic explanations for the regularly occurring stigmata of the would-be saint Louise Lateau. He even proposed an experiment to test the regularity of their occurrence. His commitment to freedom was such that in 1882, in the midst of the rising tide of positivism, he published an extended argument for the role of freedom, not only in human affairs, but also in the whole material world [Duyckaerts, 1992, 11-13]. |
When he finally turned
his attention to hypnosis, during the last ten years of his life, these
philosophic commitments colored his approach and influenced his conclusions.
His approach was not that of a neuroscientist, seeking to establish new
disease prototypes, or that of a medical doctor attempting to treat patients.
As a philosopher with a deep commitment to freedom, he was reluctant to
see hypnotic phenomena as either the result of disease, like Charcot, or
as the result of mental passivity, as did Bernheim. As a rationalist
he was determined to find simple explanations for his observations, As
an experimental psychologist he was prepared to test these explanations
by constructing experiments designed to prove them false. What
is particularly intruiging for the historian of psychiatry is that Delboeuf's
skeptical, rationalist, libertarian, and experimental outlook led him not
only to a reconsideration of the phenomenon of hypnosis but to a reconsideration
of the history of hypnosis itself.
His first introduction
to animal magnetism, as it was still known, was in college. Reading about
a miraculous cure he turned to the library to see what he could read on
the subject. By luck he came upon Alexandre Bertrand's Treatise
on Somnambulism, written in the 1820s [Delboeuf, 1886a, 441]. Bertrand
is well known as a skeptic about the 'fluidist' explanations, who
, rather than dismissing the observed phenomena out of hand, sought
other explanations. Delboeuf was to adopt a very similar orientation towards
the hypnotic phenomena he later observed. Bertrand is less well known
for his insightful social-psychological analysis of the controversies
swirling around in the 1820s. Bertrand regarded those who saw themselves
as possessed by demons and those who felt infused with magnetic fluid as
equally unreliable witnesses of what was actually influencing them. He
saw the phenomena displayed by these very different subjects as originating
in the imagination of a subject. Her magnetizer or exorcist was so impressed
by this that he later unconsciously molded other subjects to resemble her
[Bertrand, 1823]. Without directly citing Bertrand, Delboeuf was
later to offer a very similar analysis of the controversies of the 1880s.
Bertrand's influence, however, undoubtedly guided Delboeuf's own experiments
and helped him reach his conclusions as rapidly as he did.
Delboeuf's direct
involvement in hypnosis began in December 1885, when he visited Charcot's
clinic in Paris. He had dabbled with hypnosis previously, but lore about
its dangers and the stigma attached to its practitioners had always
limited how far he went. In Paris he had strong philosophical reasons
to challenge one of Charcot's fundamental findings. Delboeuf was
concerned by the observation that, on waking, somnambulists could not remember
what had occurred during 'sleep'. This troubled him because he had a metaphysical
commitment to the idea that nothing, not even a memory, is permanently
lost from the universe. Because he regarded personal memory as defining
the self, which was the basis of personal identity, the failure to
remember what occurred during hypnotic sleep also created the paradox
of a person with two identities.
At the start of his investigations Delboeuf accepted the
commonly held nineteenth century assumptions that hypnosis was a form of
sleep and that somnambulism was a form of dreaming. Based on these assumptions
was sure that there must be conditions which would allow for
remembering what occurred during somnambulism just as there were conditions
that allowed for remembering dreams. After Charcot's students
demonstrated that subjects did forget what they had done after being awoken
from a somnambulistic state, Delboeuf created an experiment in which subjects
were woken in the midst of putting out an imaginary fire. As he predicted,
they remembered the fire as if it were a dream.
As a newcomer to hypnosis Delboeuf viewed Charcot's demonstrations
with respect. Nonetheless a number of observations aroused his skepticism.
He thought that pictures of ecstatic saints lining the waiting room offered
suggestions to patients on how to behave when hypnotized. Charcot's
first patient greeted him with such familiarity that Delboeuf thought
that she resembled an experimental subject more than a sick person [Delboeuf,
1886, 123]. As he watched Charcot's demonstration of catalepsy, one of
the three characteristic stages of hypnosis, Delboeuf recalled that stage
hypnotists had demonstrated the same phenomena at least forty years earlier
[Delboeuf, Oct 1886, 125].
It was important to
Delboeuf's perspective on hypnosis that he never made a distinction between
hypnotic phenomena created by stage hypnotists and those observed by doctors.
Indeed he seems to have identified more with the stage hypnotists than
with the doctors. Even before going to Paris to observe Charcot, Delboeuf
had published an anonymous defense of the stage hypnotist Donato,
who had been dismissed as a charlatan by “les Parisiens” . Delboeuf saw
the medical critique of stage hypnotists as largely turf protection and
efforts to legally curtail the activities of men like Donato as an unwarranted
and even dangerous restriction of human freedom. His familiarity
with the work of these 'charlatans' was an important source of his understanding
of the social-psychology of healing movements.
After observing Charcot's demonstrations, Delboeuf was
inclined to agree with Bernheim that such phenomena were the result of
unconsciously suggestive maneuvers [Delboeuf,Oct 1886, 125]. His conclusions
were not, however altogether in accord with Bernheim's, revealing the influence
of Delboeuf's convictions about human freedom. Delboeuf concluded
that what he had observed was due, not just to unconsciously suggestive
maneuvers on the part of the hypnotist, but to an excessive willingness
to accommodate [un excèss de complaisance] on the part of
their subjects. "They could speak,' he insisted, for example, 'but they
felt a duty to be quiet' [Delboeuf, Oct 1886, 147].
After leaving
Paris, Delboeuf did not go directly to Nancy to observe Bernheim but returned
home to Liege to try to reproduce Charcot's results for himself. He initially
accepted Charcot's view that hypnosis was easier to induce in hysterical
patients, but achieved only mixed results with such patients. Remembering
Bernheim's claim that hypnosis were easier to produce in healthy, but simple
subjects, Delboeuf began a series of experiments using two sisters who
were his servants, without apparent concern about the influence of
his role as master on his servants as subjects. Perhaps this worked because
Delboeuf conducted his hypnotic sessions like a philosophy professor teaching
a new student, at times speaking of giving his subjects 'a little lesson
in psychology' [Delboeuf, May, 1886,455]. If his authority facilitated
their learning, so much the better.
When his experiments
with the younger sister, M, were disappointing, Delboeuf decided
to try to hypnotize the older sister, J., although he thought she would
give him more trouble as a subject, because she was more intelligent than
her sister. Contrary to these expectations, she rapidly entered a
state of somnambulism and he was able get her to demonstrate a wide range
of the phenomena he had observed in Paris. Delboeuf’s interpretation
of J…’s rapid progress is remarkable for its contrast with with the
the interpretations that both the Salpêtrière and the Nancy
schools would have given to such performances. To Charcot and his followers
J… would have to have been a hysteric. To Bernheim and his followers
she would have been considered merely suggestible. In either case the power
would lie in the hands of the hypnotist, while the subject would be either
sick or extremely passive.
For Delboeuf
their roles were reversed. First, he marveled at her “intelligence,”
self-consciously emphasizing it was her intelligence that allowed
her to learn just what he wanted her to do so quickly and completely that
a spectator could not discern just how he communicated his wishes to her.
Second, he modestly noted that if his psychological studies had not
put him on guard, he could have been fooled into believing that he had
influenced her by his thought or will.
His realization that his servant was smart enough to fool him,
and that he was potentially gullible enough to be fooled into believing
that he had power over her, opened the door to his realization that this
dynamic could well have been working between largely female subjects and
largely male hypnotists throughout the nineteenth century. This must
have been, he added, how many magnetizers, honestly, came to believe in
the power of their will [Delboeuf, 1886b, 153-4].
While Delboeuf
was conducting his experiments with J..., he was invited to observe
the work of an amateur magnetizer with a group of teen age boys, all of
whom behaved in the same manner when hypnotized. Because of his familiarity
with the stage hypnotist Donato, Delboeuf immediately realized that
these subjects must have ‘passed through Donato's hands'. As Delboeuf
knew, when Donato arrived in a new city, he recruited a cadre of subjects,
usually of adolescent boys, who he trained in his method, or as Delboeuf
put it, 'poured into his mold'. During public performances
Donato called upon these subjects to do things that provoked astonishment
and laughter in the audience. It was a group of these boys that the
magnetizer had unwittingly discovered, and had made no effort to reshape.
Because Delboeuf did
not make the standard distinction between hypnosis as used in science and
in entertainment, it appeared obvious that the type of subject that Donato
created for his commercial purposes was a third type of hypnotic subject
along with those “discovered” at the Salpêtrière and at Nancy.
Donato’s boys had volunteered to be hypnotic subjects and might be seen
as motivated to produce the best possible performance. Indeed, he
added, he could put his subject J… into a forth category.
Expanding the number
of categories of hypnotic subjects by accepting the legitimacy of his own
subject J… as well as Donato’s subjects on the same footing as those of
both Charcot and Bernheim had important implications for his thinking.
His conclusion from this insight is worth quoting:
…if the subjects from Salpêtrière and those from Nancy
present such remarkable differences, they have probably come from
a certain type of training in part intentional, in part unconscious, in
part accidental. The hypnotists would have been …inspired by the first
results that they obtained and would have endeavored to obtain them subsequently,
believing that they were essential and characteristic; the subjects, so
influenced and almost guided, would have in their turn be used as models
by newcomers who saw them or who heard them talked about; there would be,
in this way, instituted a latent teaching supported by different traditions
according to the milieux, and so would have given rise to types of schools
in conflict today.
Delboeuf's conclusion
relates not only to the schools in conflict in his day but also to the
schools in conflict in our day. More is at stake, however, than an original
subject persuading her therapist, hypnotist, magnetizer or exorcist of
the genuineness of her performance and he then training future subjects
and students in his school. The first subject, her handler as well as future
subjects and handlers must be prepared to accept a particular interpretation
of the observed phenomena. In one period, demons have explained things
for some. In other periods magnetic fluids, messages from the dead and
more recently alters. Polarization occurs between those who are prepared
and trained to see and believe and those who are not. The process
that Delboeuf, and Bertrand before him, described helps explain how such
polarizing conflicts develop and perhaps assures that they will continue
to recur.
Not satisfied with
having established this typology of hypnotic subjects, Delboeuf, the experimentalist,
also attempted to show that he could transform one type into another. Using
imitation, he decided to produce hypnotic subjects in the same
mold. First, he had M., who did nothing more than 'sleep', when he
hypnotized her, watch J… demonstrate lethargy and catalepsy.
As predicted M… was now able to enter these states, something she previously
could not do. In a second experiment he had two of Donato’s subjects,
who had their own type of hypnotic performance, watch J. and M.
In a short time Delboeuf was able to get Donato's subjects to imitate J.
and M. point for point. Not only was Delboeuf able to get these subjects
to change type, but once they did so they continued to display the new
set of hypnotic behaviors. The stability of this learned behavior
as well as the failure to observe the learning, Delboeuf argued, created
the illusion that scientists like Charcot were discovering naturally occurring
phenomena.
Having recognized
how types of subjects are created and modified, as well as how hypnotists
deceive themselves into overestimating their power, Delboeuf was in a position
to critique the very assumptions with which he had begun his investigations,
namely that hypnosis was a form of sleep. Delboeuf's attitude toward his
subjects and his relationships with his subjects were already quite different
from either those of Charcot or Bernheim. This led to different perceptions
of what was going on during hypnosis. On the question of what, if anything
was on subjects’ minds while they were in a state of hypnotic sleep
it was easy to assume that nothing was on their minds. Indeed when asked
they usually said that they were thinking of nothing. Delboeuf, however,
noticed that J… was hardly indifferent to sounds around her. When
asked, for example, to wake when the clock struck a particular
time, she never failed to do so. For Delboeuf this was clear evidence of
mental activity [Delboeuf, 1886b, 155]. With another subject
S., who was unusual for the time in that she volunteered to be a subject,
Delboeuf, who no longer believed subjects had to forget their somnambulistic
state, could simply ask what was on her mind. In a series of experiments
where he forbid her from doing things such as writing the number
“7”, she complied but became sad. When he asked her why she was so sad
she replied, " I cannot do what I want. M. Delboeuf had forbidden me to
write ‘7’. It is in spite of myself. I am sad because of the uselessness
of the efforts that I make.” Delboeuf found S.’s belief that she
was not free and her revolt against the constraints he had imposed on her
confirmed his view that subjects are not simply clay in the hands of their
hypnotizers. [ Magnétisme Animal 18-19]
Delboeuf began his
investigations persuaded that hypnosis was a form of sleep and somnambulism
was a form of dreaming. These comparisons were essential to his efforts
to refute the philosophically provocative assertion that subjects cannot
remember their somnambulistic state on waking. Initially, while visiting
Charcot in Paris, he attempted to create conditions that allow for remembering.
Later he concluded that the whole question of remembering or forgetting
was a matter of the type of somnambulist one created. He began to see the
idea of hypnosis as a form of sleep as useful metaphor for creating certain
phenomena. Making use of this metaphor depended, in turn, on the subject's
willingness to accept the hypnotist's suggestion that she was 'asleep.'
With this insight Delboeuf went on to claim, somewhat tongue in cheek,
that there was no such thing as hypnosis [Delboeuf, 1891-2]. In the last
paper that he wrote before his death in 1896, at the age of 65, he more
seriously suggested that the term hypnosis no longer be used because it
created the misimpression that sleep was involved in the process. Instead
he suggested that the term hypnosis be replaced by the term 'psychotherapy',
or better yet 'psychodynamics' [Delboeuf, 1892-3]. With this suggestion
Delboeuf completed his liberation from the mold of nineteenth century ideas
about hypnosis and opened the way to twentieth century ideas about the
collaboration of patient and therapist. Perhaps it is not surprising
that Freud found so much to learn from the modest Belgian philosopher,
who believed in freedom.
Edward M. Brown
As presented to the European Association for the History of Psychiatry,
Madrid, Spain, September 2002.
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